#278 ‒ Breast cancer: how to catch, treat, and survive breast cancer | Harold Burstein, M.D., Ph.D.

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Nov 6, 2023

Harold Burstein, an esteemed breast cancer expert and professor at Harvard Medical School, shares his extensive knowledge on breast cancer. He breaks down the complexities of breast anatomy and discusses various forms of breast cancer, from precancerous lesions to invasive types. Insights into screening methods, including mammograms and MRIs, reveal the ongoing debates about early detection. Burstein also highlights the genetic factors at play, the rarity of male breast cancer, and the importance of personalized treatment plans for improved outcomes.

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INSIGHT

Breast Cancer Statistics

American women have a one in eight lifetime risk of breast cancer.
Only a small fraction of breast cancer cases are fatal, with 80-85% being cured.

INSIGHT

Breast Anatomy and Cancer Development

Breast size is determined by fatty tissue, not glandular tissue, where cancer arises.
Increased breast cancer incidence may be linked to earlier puberty and longer menstruation.

ANECDOTE

Environmental Influence on Breast Cancer

Japanese women migrating to the U.S. saw breast cancer rates rise to match American women within a generation.
This suggests a strong environmental component to breast cancer risk.

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Harold (Hal) Burstein is an internationally renowned breast cancer expert. In this episode, Hal discusses a broad range of topics related to breast cancer, starting with the intricacies of breast anatomy and the endocrinological factors at play. He covers the spectrum of breast cancer, from precancerous lesions to invasive breast cancer, classifying these conditions into a helpful framework. He delves into various screening methods, including self-exams, mammograms, ultrasounds, and MRIs, and addresses the ongoing debate surrounding early screening and detection. Hal provides insights into the latest advancements in cancer treatment, offering valuable guidance for individuals to understand their unique circumstances within the three primary categories of breast cancer. Finally, Hal delves into the role of genetics in breast cancer and brings attention to the less commonly addressed issue of male breast cancer.

We discuss:

The prevalence and mortality rate of breast cancer in women [4:15];
The anatomy of the breast and the complex factors behind breast cancer development [6:30];
The three main categories of breast cancer [16:45];
Breast cancer risk: the impact of menopause, estrogen, breast density, obesity, and more [21:15];
Finding and evaluating lumps in the breast [25:30];
Identifying and treating precancerous lesions like ductal carcinoma in situ (DCIS) [31:00];
Post-lumpectomy for DCIS: standard of care, future risk of cancer, and pros and cons of radiation and other preventative options [41:15];
Lobular carcinoma in situ (LCIS): how it differs from DCIS in terms of treatment and future risk of invasive cancer [55:00];
Breast cancer screening: mammography, ultrasound, MRI, and more [1:03:45];
Invasive breast cancer: pathology report, surgery, and survival [1:11:00];
The argument for aggressive screening for breast cancer [1:22:15];
Advances in the treatment of breast cancer, adjuvant therapy, and neoadjuvant therapy [1:27:00];
The use of hormone replacement therapy in women who are in remission from breast cancer [1:41:15];
The role of genetics in breast cancer [1:44:45];
The importance of multidisciplinary care delivered by cancer centers [1:53:15];
Breast cancer in men [2:03:30];
Parting thoughts and takeaways [2:05:45]; and
More.

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